Provider Demographics
NPI:1215759816
Name:OJUNKWU, JUDITH G (APN)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:G
Last Name:OJUNKWU
Suffix:
Gender:
Credentials:APN
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:G
Other - Last Name:OGBONNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 JOHN JAMES AUDUBON WAY
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-7200
Mailing Address - Country:US
Mailing Address - Phone:856-278-2041
Mailing Address - Fax:
Practice Address - Street 1:822 KLEMM AVE
Practice Address - Street 2:
Practice Address - City:GLOUCESTER CITY
Practice Address - State:NJ
Practice Address - Zip Code:08030-1627
Practice Address - Country:US
Practice Address - Phone:856-282-5566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-26
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15183200363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health